It's Richard's birthday. He's expecting a surprise party. Instead, he gets a folder filled with information on retirement. In other news, a man, Greg, comes into the hospital for treatment on a pain he's had for 10 years. Bailey sees a mass inside the guy. She orders Leah to keep mum until they do more tests. She's positively giddy when she realizes what it is. Bailey wants Richard in on the case. Why? Well, it's his birthday!
In all his years of practicing medicine, Dr. Richard Webber has never seen anything like this. The patient with the stomach pains absorbed his twin inside his body when he was born. Greg needs a moment to, no pun intended, digest this. He just found out he has a brother. Greg interrupts Richard's parade of teaching moments to let all the docs know that he doesn't want his twin removed. He won't sign the consent. It would be like destroying the Mona Lisa.
Richard convinces Greg to let him take out the fetus. He won't throw it away. He'll keep it safe in a jar. He does it all the time. The surgery is a go. Everyone is in awe of what's happening. Richard gives a speech as to how something like this needs to be shared. It's not something should ever be thrown away. Of course, Greg completely freaks out when he sees what was inside of him. He orders it to be tossed. That's cool. Richard will hold onto it.
Shane meets with candidates for Cristina's clinical trial. An expectant mother, Cheryl, crashes his interviews claiming she's the perfect test case. She wants a heart that's going to survive the birth of her child in six weeks. Actually, it's not going to be that long. Cheryl's water just broke. Shane wants Cristina to break the rules to help this lady. She can't jeopardize the trial though. Cheryl has a difficult delivery, but Shane helps her through it. She's a brand new mom, but she still doesn't meet the criteria for the study.
Derek's surgery is suddenly canceled. That's because Callie went to Owen with a concerns over the intellectual property of the sensors they've been developing. She also has a lawyer. Derek tries to appeal to Callie in private. It doesn't go well. Callie believes Derek thinks he's the white hot center of the universe. She even draws it out on a board. Her design looks a little like a butt hole. Either way it works. Callie's impassioned speech has Derek telling the most powerful people in the nation that they all need to share. So that's what they'll be doing.
Catherine Avery is in the house! She's not too happy meets up with her baby boy and his brand new bride. Jackson and April got hitched before they met with the lawyer who protects the Avery Foundation's interests. Catherine wants her new daughter-in-law to sign a post-nuptial agreement. April is game but Jackson nixes the notion.
Eventually, April convinces Jackson to cave on the post-nup. But the ensuing conversation is a volatile one once Catherine lays out exactly what it means to be an Avery. April assures them they'll figure all that out. She also apologizes for all the people they hurt with their sudden marriage. April tells Jackson to apologize to his mom, too. Mother and son ultimately hug it out. Still, this entire situation has Jackson and April realizing the really haven't thought out their future together.
In random news, an enthusiastic bioengineer, Eric, has been hired to work on Meredith's clinical trial. He's to touch nothing. Boss's orders. Then Meredith changes her mind. They need to get to work pronto. Elsewhere, Jo refuses to sign the love contract even though Alex taunts her with all the cool surgeries she's missing because of her stubbornness. She eventually relents. Cristina wants Owen to try online dating. She even helps him write a profile. Owen's description of what he wants sounds an awful lot like what he had with Cristina.
At the end of the day, Richard chats with Catherine about the retirement papers he was given earlier. He silences her ensuing lecture with a kiss. Then Richard walks in on the surprise party he actually finds truly surprising. The bombshells continue to fly as Owen asks him to be director of the residency program. Then everyone toasts the man of the hour. It turns out that this was a happy birthday after all.